Nakano Hideyuki, Terashima Hiroko, Hasebe Hiruma, Fukuchi Takeo
Department of Ophthalmology, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan.
Department of Ophthalmology, Niigata City General Hospital, Niigata, Japan.
Sci Rep. 2025 Jul 1;15(1):21537. doi: 10.1038/s41598-025-08269-8.
Macular hole (MH) retinal detachment (MHRD) frequently causes severe visual impairment, mainly in older people with severe myopia and posterior staphyloma. Vitrectomy combined with internal limiting membrane (ILM) peeling is a treatment but has issues. The usefulness of an ILM inverted flap technique has not been clearly defined. Thus, we compared vitrectomy using this technique with vitrectomy using a complete ILM peeling technique for MHRD with severe myopia. The study included 29 patients (29 eyes) who underwent initial vitrectomy for MHRD with severe myopia between January 2011 and August 2019. The inverted ILM flap technique was used in 12 eyes (inverted group), and the complete ILM peeling technique was used in 17 eyes (peeling group). Clinical findings and outcomes were compared. In the peeling and inverted groups, the initial MH closure rate was 35.3% and 50% (p = 0.024) and the initial retinal reattachment rate was 82.4% and 75.0% (p = 0.630), respectively. The final retinal reattachment rate was 100% in both groups. The postoperative visual acuity during final consultation was better in the inverted than the peeling group. The inverted ILM flap technique may be more useful than the ILM peeling technique for MHRD in severely myopic eyes.
黄斑裂孔性视网膜脱离（MHRD）常导致严重视力损害，主要见于患有高度近视和后巩膜葡萄肿的老年人。玻璃体切除术联合内界膜（ILM）剥除术是一种治疗方法，但存在问题。ILM翻转瓣技术的有效性尚未明确界定。因此，我们比较了使用该技术的玻璃体切除术与使用完全ILM剥除技术的玻璃体切除术治疗高度近视性MHRD的效果。该研究纳入了2011年1月至2019年8月期间因高度近视性MHRD首次接受玻璃体切除术的29例患者（29只眼）。12只眼采用ILM翻转瓣技术（翻转组），17只眼采用完全ILM剥除技术（剥除组）。比较临床发现和结果。在剥除组和翻转组中，初始黄斑裂孔闭合率分别为35.3%和50%（p = 0.024），初始视网膜复位率分别为82.4%和75.0%（p = 0.630）。两组最终视网膜复位率均为100%。最终会诊时，翻转组的术后视力优于剥除组。对于高度近视眼的MHRD，ILM翻转瓣技术可能比ILM剥除技术更有用。
